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World Health Systems Facts

Italy: Long-Term Care

Italy: Long-Term Care

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Population, Mid-Year 2019: 60,550,000
Projected Population Mid-Year 2030: 59,031,000
Percentage of Population Under Age 25 Years, Mid-Year 2019: 23%
Percentage of Population 65 Years Or Over, Mid-Year 2019: 23%

Source: United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Prospects 2019: Data Booklet (ST/ESA/SER.A/424).


Adults Aged 65 and Over Rating Their Own Health as Fair, Poor or Very Poor, 2019: 60.2%
People With Dementia Per 1,000 Population, 2021: 23.7%
Projected Number of People With Dementia Per 1,000 Population in 2050: 42.7%
Long-Term Care Workers Per 100 People Aged 65 And Over, 2019: 4
Long-Term Care Beds in Institutions and Hospitals per 1,000 Population Aged 65 and Over, 2019: 19.4
Total Long-Term Care Spending as a Share of GDP, 2019: 0.9%

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


Long-Term Care Recipients In Institutions Other Than Hospitals, Total All Ages 2019: 479,807
Long-Term Care Recipients At Home, Total All Ages, 2019: 1,047,223

Source: Organization for Economic Cooperation and Development. OECD.Stat. Last accessed June 18, 2022.


“Sustained gains in life expectancy combined with low fertility rates over the last two decades have contributed to a steady rise in the share of the population aged 65 and over. In 2017, more than one in five Italians was aged 65 years and over, up from only one in eight in 1980; this share is projected to increase to around one in three people by 2050.

“In 2017, life expectancy at age 65 reached nearly 21 years, one year above the EU average (Figure 4). However, as in other countries, Italians spend slightly more than half of these additional years of life after 65 with some health issues and disabilities. The gender gap in life expectancy at age 65 is about three years in favour of women, but there is no gender gap in the number of healthy life years because Italian women live a greater proportion of their lives in old age with some health issues and disabilities.

“Slightly less than half of Italians aged 65 and over reported having at least one chronic disease in 2017, which is lower than the EU average. Most people are able to continue to live independently in old age, but one in six Italians aged 65 and over reported in 2017 some limitations in basic activities of daily living, such as dressing and eating, which may require long-term care assistance. About four in ten people aged 65 years and more reported some depression symptoms, a higher proportion than the EU average.”

Source: OECD/European Observatory on Health Systems and Policies (2019), Italy: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“In 2050, one in three Italians are expected to be over 65 years old. Socioeconomic developments (e.g. decrease in multi-generational family units and an increase in female participation in the labour market) have contributed to reducing the availability of family caregivers to provide care and assistance to the elderly. Therefore, residential health facilities or retirement homes (Residenze Sanitarie Assistenziali, RSA) have been subject to a rapid, demand-driven expansion in the last two decades. Currently, there are 18.6 available RSA beds for every 1 000 older residents in Italy, well below the OECD average of 43.8, and these are mainly in central and northern Italy. It is difficult, however, to provide precise estimates since Italian regions use different denominations and organizational models, encompassing retirement homes, geriatric rehabilitation institutes, etc. Overall, RSAs are open-ended or temporary residence facilities. The Ministry of Health has indicated that they should be integrated within the existing urban fabric, in areas well connected by public transport, to avoid isolation. Their capacity can vary from 20 to 120 places, divided into modules of 20 residents each. One quarter of the available modules should be reserved for residents with dementia. Some RSAs have an “Alzheimer’s Nucleus”, an area dedicated to patients with cognitive and behavioural disorders.

“RSAs are mainly private. Local health authorities or social services regulate access to public or accredited RSAs upon GP’s or hospital doctor’s request, organize visits to the geriatric evaluation unit, and manage waiting lists. Only health service costs are borne by the SSN and vary according to the level of assistance provided. The remaining costs are borne by patients, municipalities and, indirectly, by the National Institute for Social Security (Istituto nazionale della previdenza sociale, INPS). Italy does not offer insurance136 Health Systems in Transitionfor long-term care; however, a universal national allowance (Indennità di accompagnamento; EUR 525 per month in 2022) is granted by Law 18/1980, irrespective of income status, to non-self-sufficient individuals. Large regional variations exist with regard to the additional resources topped up by other government entities (regions, municipalities).”

Source: de Belvis AG, Meregaglia M, Morsella A, Adduci A, Perilli A, Cascini F, Solipaca A, Fattore G, Ricciardi W, Maresso A, Scarpetti G. Italy: Health system review. Health Systems in Transition, 2022; 24(4): pp.i–203.


“Long-term care for elderly, cognitively or physically disabled people also can be provided in semi-residential settings, such as day centres. These centres provide social, health, rehabilitation, and educational services to people usually aged 18–65 years (although younger people can also be admitted) on the basis of individual projects (Ministero della Salute, undated). Similarly, integrated day centres (Centri Diurni Integrati, CDI) offer social and health care and services to people over 60.

“Lastly, the SSN guarantees home care, i.e. assistance in one’s own home, to non-self-sufficient people or those in a frail condition. Home care services are included in the national benefits package and thus are entirely paid by the SSN, upon a preliminary multidisciplinary evaluation of the patient’s health and social condition. Home care is divided into “scheduled home care” (Assistenza Domiciliare, AD) that provides medical, nursing and/or rehabilitation health services limited to the episode of illness in progress, and “integrated home care” (Assistenza Domiciliare Integrata, ADI) that consists of an integrated set of health and social treatments, delivered in a coordinated and continuous manner. Moreover, “home hospitalization” is a service characterized by diagnostic, therapeutic and rehabilitative services of high complexity and defined duration, provided by a specialist team usually recruited from hospitals.”

Source: de Belvis AG, Meregaglia M, Morsella A, Adduci A, Perilli A, Cascini F, Solipaca A, Fattore G, Ricciardi W, Maresso A, Scarpetti G. Italy: Health system review. Health Systems in Transition, 2022; 24(4): pp.i–203.


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.


Page last updated Feb. 4, 2023 by Doug McVay, Editor.

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